Health screenings for women over age 65
You should visit your health care provider from time to time, even if you are healthy. The purpose of these visits is to:
- Screen for medical issues
- Assess your risk for future medical problems
- Encourage a healthy lifestyle
- Update vaccinations
- Help you get to know your provider in case of an illness
Health maintenance visit - women - over age 65; Physical exam - women - over age 65; Yearly exam - women - over age 65; Checkup - women - over age 65; Women's health - over age 65; Preventive care exam - women - over age 65
Even if you feel fine, you should still see your provider for regular checkups. These visits can help you avoid problems in the future. For example, the only way to find out if you have high blood pressure is to have it checked regularly. High blood sugar and high cholesterol levels also may not have any symptoms in the early stages. A simple blood test can check for these conditions.
There are specific times when you should see your provider. Below are screening guidelines for women over age 65.
BLOOD PRESSURE SCREENING
- Have your blood pressure checked at least once every year. If the top number (systolic number) is between 120 and 139 or the bottom number (diastolic number) is between 80 and 89 mm Hg or higher, have it checked every year.
- If the top number is greater than 140, or the bottom number is greater than 90, schedule an appointment with your provider.
- If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.
- Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked.
CHOLESTEROL SCREENING AND HEART DISEASE PREVENTION
- If your cholesterol level is normal, have it rechecked at least every 5 years.
- If you have high cholesterol, diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.
COLORECTAL CANCER SCREENING
Until age 75, you should have screening for colorectal cancer on a regular basis. If you are age 76 or older, you should ask your doctor if you should receive screening. Several tests are available for colorectal cancer screening:
- A fecal occult blood (stool-based) test every year
- A fecal immunochemical test (FIT) every year
- A stool DNA test every 3 years
- Flexible sigmoidoscopy every 5 years
- Double contrast barium enema every 5 years
- CT colonography (virtual colonoscopy) every 5 years
- Colonoscopy every 10 years
You may need a colonoscopy more often if you have risk factors for colon cancer, including:
- Ulcerative colitis
- A personal or family history of colorectal cancer
- A history of growths called adenomatous polyps
- Go to the dentist once or twice every year for an exam and cleaning. Your dentist will evaluate if you have a need for more frequent visits.
- If you are age 65 or older and in good health, you should be screened for diabetes every 3 years.
- If you are overweight and have other risk factors for diabetes, ask your provider if you should be screened more often.
- Have an eye exam every 1 to 2 years.
- Have an eye exam at least every year if you have diabetes.
- Have your hearing tested if you have symptoms of hearing loss.
- If you are over age 65, get a pneumococcal vaccine.
- Get a flu shot every year.
- Get a tetanus-diphtheria booster every 10 years.
- You may get a shingles or herpes zoster vaccination at age 50 or older.
- Have a yearly physical exam.
- With each exam, your provider will check your height, weight, and body mass index (BMI).
- Routine diagnostic tests are not recommended unless your provider finds a problem.
During the exam, your provider will ask questions about:
- Your medicines and risk for interactions
- Alcohol and tobacco use
- Diet and exercise
- Safety, such as seat belt use
- Whether you have had falls
- Women may do a monthly breast self-exam. However, experts do not agree about the benefits of breast self-exams in finding breast cancer or saving lives. Talk to your provider about what is best for you.
- Contact your provider right away if you notice a change in your breasts, whether or not you do self-exams.
- Your provider may do a clinical breast exam during your preventive exam. Experts do not agree on the benefit of a breast examination.
- Women up to age 75 should have a mammogram every 1 to 2 years, depending on their risk factors, to check for breast cancer.
- Experts do not agree on the benefits of having a mammogram for women age 75 and older. Some do not recommend having mammograms after this age. Others recommend mammography for women in good health. Talk to your provider about what is best for you.
- All women over age 64 should have a bone density test (DEXA scan).
- Ask your provider which exercises can help prevent osteoporosis.
PELVIC EXAM AND PAP SMEAR
- After age 65, most women who have not been diagnosed with cervical cancer or precancer can stop having Pap smears as long as they have had three negative tests within the past 10 years.
LUNG CANCER SCREENING
The US Preventive Services Task Force recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults until age 80 who:
- Have a 30 pack-year smoking history AND
- Currently smoke or have quit within the past 15 years
American Academy of Ophthalmology website. Policy statement: frequency of ocular examinations - 2015. www.aao.org/clinical-statement/frequency-of-ocular-examinations. Updated March 2015. Accessed April 15, 2019.
American College of Obstetricians and Gynecologists. Practice bulletin no. 168: cervical cancer screening and prevention. Obstet Gynecol. 2016;128(4):e111-e30. PMID: 27661651 www.ncbi.nlm.nih.gov/pubmed/27661651.
American Dental Association website. Your top 9 questions about going to the dentist -- answered. www.mouthhealthy.org/en/dental-care-concerns/questions-about-going-to-the-dentist. Accessed April 15, 2019.
American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes - 2019. Diabetes Care. 2019;42(Suppl 1):S13-S28. PMID: 30559228 www.ncbi.nlm.nih.gov/pubmed/30559228.
Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 12.
Brown HL, Warner JJ, Gianos E, et al; American Heart Association and the American College of Obstetricians and Gynecologists. Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists: a presidential advisory from the American Heart Association and the American College of Obstetricians and Gynecologists. Circulation. 2018;137(24):e843-e852. PMID: 29748185 www.ncbi.nlm.nih.gov/pubmed/29748185.
Cosman F, de Beur SJ, LeBoff MS, et al. Clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int. 2014;25(10):2359-2381. PMID: 25182228 www.ncbi.nlm.nih.gov/pubmed/25182228.
James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520. PMID: 24352797 www.ncbi.nlm.nih.gov/pubmed/24352797.
Kim DK, Hunter P. Advisory Committee on Immunization Practices recommended immunization schedule for adults aged 19 years or older - United States, 2019. MMWR Morb Mortal Wkly Rep. 2019;68(5):115-118. PMID: 30730868 www.ncbi.nlm.nih.gov/pubmed/30730868.
Meschia JF, Bushnell C; American Heart Association Stroke Council; et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838 www.ncbi.nlm.nih.gov/pubmed/25355838.
Moyer VA; US Preventive Services Task Force. Screening for lung cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330-338. PMID: 24378917 www.ncbi.nlm.nih.gov/pubmed/24378917.
Ridker PM, Libby P, Buring JE. Risk markers and the primary prevention of cardiovascular disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 45.
Siu AL; US Preventive Services Task Force. Screening for breast cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164(4):279-296. PMID: 26757170 www.ncbi.nlm.nih.gov/pubmed/26757170.
Siu AL; US Preventive Services Task Force. Screening for high blood pressure in adults: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163(10):778-786. PMID: 26458123 www.ncbi.nlm.nih.gov/pubmed/26458123.
Smith RA, Andrews KS, Brooks D, et al. Cancer screening in the United States, 2019: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2019;69(3):184-210. PMID: 30875085 www.ncbi.nlm.nih.gov/pubmed/30875085.
Stone NJ, Robinson JG, Lichtenstein AH, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S1-S45. PMID: 24222016 www.ncbi.nlm.nih.gov/pubmed/24222016.
Studenski S, Van Swearingen J. Falls. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier; 2017:chap 103.
US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2016;315(23):2564-2575. PMID: 27304597 www.ncbi.nlm.nih.gov/pubmed/27304597.
US Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening for cervical cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018;320(7):674-686. PMID: 30140884 www.ncbi.nlm.nih.gov/pubmed/30140884.
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Internal review and update on 04/15/2019 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.